WHY NP PRACTICES NEED “VALUE AGGREGATORS”: LET’S TALK MONEY

WHY NP PRACTICES NEED “VALUE AGGREGATORS”: LET’S TALK MONEY NP practice owners are entrepreneurs who want to be independent—to be free-standing.  But best case, these independents will each see 1500 patients, and a 1500 patient panel is too small to create contracting leverage, even with remarkable outcomes that are reliably great.  But if 10 NP practices, each with 1500 patient panel, combine their quality data, 15,000 lives begins to have credibility. Who collects the data and leverages these 10 NP practices’ outcomes into some share of the savings flowing to the NPs?  Who supports the business end of the 10 practices so the NPs can do what they love?  Below I propose the not-so-new idea of a value aggregator as the entity that brings the necessary capabilities to the table to give those 10 practices “the independence they want and the support that they need”.  What will success of an NP value aggregator look like?  I vote for negotiation of payment models that leverage the quality and cost value the nursing process invariably produces. At NNPEN’s second annual conference, Minneapolis 2018, we saw an independent (indie) NP practice profile developing: maybe no brick and mortar office space, outsourced backroom functions, digital clinical platform, and miserly (even in FPA states) commercial insurer payments, based on an unsustaining Fee For Service schedule at 85% of Medicare’s Physician rate.  And adding insult...

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